| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,513.56 | $1,819.70 | $2,398.83 |
Aetna
| Professional | QZ | $239.88 | $239.88 | $239.88 |
Ambetter
| Professional | AA | $263.03 | $263.03 | $295.12 |
Ambetter
| Professional | QZ | $281.84 | $316.23 | $501.19 |